How much rates vary
Facilitymedian $525 · 10th to 90th $309 to $2,630Professionalmedian $708 · 10th to 90th $407 to $1,148
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $2,187.76 | Facility | None | $309.03 | $478.63 | $2,187.76 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $354.81 | Facility | 54 · Surgery only | $234.42 | $234.42 | $354.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $47.86 | Facility | 56 · Pre-op care only | $30.90 | $31.62 | $47.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $218.78 | $218.78 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $588.84 | Professional | None | $288.40 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $331.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,445.44 | $2,137.96 | $2,884.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,148.15 | Professional | None | $588.84 | $794.33 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $954.99 Typical High $1,380.38 | Professional | 22 · Increased work | $707.95 | $954.99 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,202.26 Typical High $1,698.24 | Professional | 50 · Both sides | $870.96 | $1,202.26 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $562.34 Typical High $794.33 | Professional | 54 · Surgery only | $407.38 | $562.34 | $794.33 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $79.43 Typical High $114.82 | Professional | 56 · Pre-op care only | $58.88 | $79.43 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,288.25 | Professional | None | $446.68 | $776.25 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $660.69 Typical High $2,511.89 | Facility | None | $309.03 | $660.69 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $2,344.23 | Professional | None | $489.78 | $891.25 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $954.99 | Professional | None | $316.23 | $588.84 | $954.99 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $239.88 | Facility | 52 · Reduced service | $154.88 | $158.49 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $95.50 | Facility | 53 · Discontinued | $61.66 | $63.10 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $72.44 | Facility | 55 · Aftercare only | $46.77 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $194.98 Typical High $239.88 | Professional | 52 · Reduced service | $154.88 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $57.54 Typical High $72.44 | Professional | 55 · Aftercare only | $46.77 | $57.54 | $72.44 |
Where North Dakota sits
The same service costs 5.2 times more in Colorado than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,833WV $936
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.